CYP2B6基因多态性与艾滋病患者HAART中依非韦仑血浆浓度的关联研究

目的研究依非韦仑（EFV）的血浆浓度与细胞色素P4502B6（CYP2B6）基因多态性的关系。方法用高效液相色谱仪（HPLC系统）测定深圳市东湖医院艾滋病专科门诊68例患者,服用EFV后8-12小时的EFV血浆浓度,用逆转录-聚合酶链反应检测所有患者的CYP2B6 516位点的G〉T基因频率。结果CYP2B6 516位点的基因型39例是GG型,26例是GT型,3例是TT型。各组EFV的血浆浓度分别是（3.3±1.2）μg/ml、（4.7±2.3）μg/ml、（9.0±0.8）μg/ml,其差异有显著的统计学意义（P〈0.01）。结论GT基因型频率在中国人相当常见,该基因型可出现较高的EFV血浆浓度;TT基因型虽然少见,但EFV血浆浓度异常升高。检测CYP2B6基因多态性可帮助临床个性化EFV用量。

Correlation between CYP 2B6 genotype and plasma EFV level in AIDS patients

Objective To study the correlation between plasma efavirenz（EFV） level and CYP450 2B6 genotype among AIDS patients receiving HAART. Methods Sixty eight AIDS patients taking EFV were recruited from a HIV/ AIDS clinic in Shenzhen. Their plasma EFV level was tested at 8- 12 hours after the previous day＇s medication, using an HPLC system. RT-PCR was used to determine the frequency of CYP2B6 516 G〉 T in the enrolled patients. Result There were 42 males and 26 females, aged 37.9 ± 10.6 years. Of them 39,26 and 3 had genotype GG, GT and TT respectively at 2B6 position 516.The EFV level was 3.3 ± 1.2μg/ml for GG,4.7 ± 2.3μg/ml for GT,and 9.0± 0.8μg/ml for TT, and the difference between them was statistically significant（ P 〈 0.01 ）. Conclusion CYP 2136 516 GT genotype is relatively common in the Chinese population. Higher plasma EFV level may appear in GT genotype, but. plasma EFV may increase to an extremely high level in TT genotype which is relatively uncommon. Therefore, the detection of CYP 2B6 516 GT genotype may help determine clinical dosage of EFV for individual patients.